Provider Demographics
NPI:1427360585
Name:HUFFMAN, SUZANNE RENATE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:RENATE
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11205 CARROLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3701
Mailing Address - Country:US
Mailing Address - Phone:813-933-0075
Mailing Address - Fax:813-554-8113
Practice Address - Street 1:11205 CARROLLWOOD DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-3701
Practice Address - Country:US
Practice Address - Phone:813-933-0075
Practice Address - Fax:813-554-8113
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1467362363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health